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Introduction: Blood Pressure Disorders (BPD) are common in the elderly and associated with significant morbidity and mortality.Aim: To summarise data from the literature and results of our investigations on the prevalence, pathophysiology, management and prognostic significance of common BPDs such as orthostatic (OH) and postprandial hypotension (PPH) and their relation to arterial hypertension(OH).Methods: MEDLINE search on BPDs and literature review.Analyses of our data on 952 patients aged 65 years and older including in-and out-patients and residents in long-term care facilities.Standard definitions of OH, PPH and HT were used.Results: BPDs in older people are very common and becoming increasingly prevalent because of demographic changes.Different types of BPDs often coexist in the same patient.In our series at least one BPD was found in 81% of patients, with multiple disorders in most.Multivariate analyses showed that PPH was significantly and independently associated with HT (OR =4.3, P<0.001), use of antipsychotic medications (OR =5.2, P =0.0007), use of selective serotonin reuptake inhibitors (OR =4.3, p =0.006) and history of smoking (OR=4.7, p=0.005), whilst OH was associated with Parkinsons disease (OR=7.5,p=0.002), use of levodopa (OR=6.1, p=0.007) and use of tricylic antidepressants (OR=3.2, p=0.015).In patients with diabetes mellitus, OH was independently associated with albuminuria (OR=3.9, p=0.001).Falls were associated with absolute low systolic blood pressure (≤ 115mm Hg) rather than with OH or PPH.In survival analysis only PPH (OR =1.66, p=0.014) and low diastolic blood pressure (≤65mmHg; OR=2.16, p=0.025) were significant predictors of all-cause mortality (5-year follow-up).Ours and majority of other studies found that adequate antihypertensive therapy ameliorates BPDs and is not associated with OH, PPH or falls.Conclusions: A unifying concept of altered haemodynamic homeostasis in the elderly should replace the current single syndrome approach.An evaluation of the whole spectrum of abnormal haemodynamic responses during everyday life in an elderly patient is crucial for individualised prognosis and therapy.